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The standard textbook description of female excitation and orgasm goes like this. A prolonged period of arousal, a plateau, orgasm proper and resolution. The same can be identified in men.

Major studies which are still often quoted are those of Kinsey and of Masters and Johnson who tackled the sensitive topic of female sexuality in what was effectively the dark ages of the post-war 20th century.

Arousal
In the excitement phase, often induced by thought alone, involves the following set of processes:

The nipples typically become erect and the clitoris also becomes turgid and it expands a little (though not much), and this may result in it becoming a bit more visible in some women with medium to large ones. Clitoral erection, more properly called tumescence, is due to increased arterial blood flow to the clitoris and reduced venous drainage and so is essentially identical to the process of penile erection but the degree of expansion is much less and involves little change in length, though the change in thickness and turgidity of the long clitoral shaft is very easily appreciated.

Increasing heart rate and blood pressure, and increasing genital blood flow also result in gradual expansion of the inner and outer labia and vaginal lubrication. Vaginal lubrication results mostly from a process called transudation that is, the increased blood flow (vasocongestion) of the vaginal wall causes blood and lymphatic fluids to be forced through the tissue into the vagina where it appears as a lot of tiny sweat-like drops on the vaginal walls. Additional vaginal lubrication comes from the cervix which is well-supplied with mucous glands. The amount and thickness of a womanıs vaginal lubrication may well depend on her stage in the menstrual cycle primarily because of the changes in the cervical mucus.

There is also lubrication of the inner lips resulting from glandular secretions from the mucous membranes and possibly from the Skeneıs glands (paraurethral glands) that open at two small, sometimes quite visible, pores, one on either side of the urethral opening (at 5 and 7 o'clock if the genitals are arranged with clitoris at 12 o'clock).

As the arousal continues, the swelling of the labia causes the inner lips to part and spread outwards thus making the opening of the vagina more obvious. The increased blood flow causes the womanıs genitals to change colour, from flesh tones to at least pinkish, but in women who have had children (it isnıt clear if pregnancy alone causes this or childbirth is important) the colour change can be more extreme and her genitals can become almost a deep wine red.

The colour of the vaginal walls also changes in the same way, and internally the vaginal cavity expands and the inner two thirds can form a rather large space; evolutionarily this is probably to produce a cavity in which sperm will be kept in close proximity to the cervix and not simply run out after the male has shed his load. On the other hand, the outer third of the vagina becomes tighter due to the increased blood flow to the region. Internally the positions of the uterus moves causing the vagina to elongate, and the position of the cervix changes collectively these changes in the internal vaginal arrangement are often referred to as "tenting." Late in the excitement phase the breasts are reported to swell, though it is hard to find detailed measurements.

Plateau
The plateau is the final phase of excitement when basically all excitement parameters are at max and she is waiting to get herself over the edge, usually focusing her thoughts very much on her genitals or other arousing things. At this time spontaneous contractions of the anal sphincter, and muscles in the upper legs and pelvic region are common, and increased semi-involuntary movements of the hips usually indicates the imminence of orgasm.

Orgasm
The orgasm is a pulsatile event with strong feelings of pleasure centered around the genitalia and a demanding pushing feeling. In women this is usually indicated visibly a series of contractions in the vaginal-anal area which occur at about once every 0.8 seconds approx. and by a "sex flush" which is a rapid change in skin colour of the chest (breasts and area between them up to the neck and face) resulting from an increase in cutaneous blood flow. The rate of perineal contractions may vary from woman to woman, and certainly not all contractions in an orgasmic series are evenly spaced, the first usually being relatively long.

Internally, a lot more is going on, and videos of the inside of the vagina during orgasm show the cervix is very active and with each contraction it pushes down and "drinks" up semen from the puddle that would be there after a normal copulation so evolutionarily it only makes sense for the woman to come after the man has and only to do so if she wants to get pregnant by him! There are also waves of contractions of the uterus which are stimulated by the orgasmic surge in the hormone oxytosin. During orgasm the woman's blood pressure and heart rate increase considerably and she often does staccato breathing and may vocalise though this may be both voluntary and involuntary depending on the individual. Some hold their breath. Many also show spastic contractions of muscles in the hands and feet causing curling of toes.

Much of the literature about female orgasm reports that during orgasm the clitoris retracts under the clitoral hood. This obviously comes from the studies of Kinsey and others. However, none of the hundreds of videos of real orgasm shown here is this visible. Also, given that the clitoris is composed of spongiform tissue without skeletal muscle, it is hard to see how this could be achieved mechanically as it certainly does not detumesce during orgasm.

The Bartholin's glands (greater vestibular glands) which open just outside the vaginal opening produce a small amount of mucus (just a few drops) and this seems to be secreted just before orgasm. It may be involved in making the chemistry of the vagina less hostile to sperm.

Resolution
After orgasm many women cannot bear continued direct stimulation of the clitoris and/or vulva (and even the breasts in some) and so pass into a resolution phase, but if the stimulation is maintained at a low level until the sensitivity subsides, avoiding direct clitoral contact, quite a lot of women can have a second or even numerous extra orgasms after the first one, separated by a minute or so. After a few orgasms it seems that clitoral sensitivity subsides and continued stimulation is possible. Possibly multi-orgasmicity is not universal in women, though it is likely that the painful, post-orgasmic sensitivity of the clitoris puts many off trying. In men it is possible but is exceedingly rare.

In early resolution there may be one or more infrequent contractions of the perineal muscles and anal sphincter that feel pleasurable (often referred top as aftershocks), but basically this is a time when the swelling of the breast and genitals slowly subsides over a period of many minutes (often about 20 mins). Failure to reach orgasm after reaching plateau can be very uncomfortable for some women because there has been no trigger to start the vascular decongestion of the genitals.

I hope this article has helped you learn a little bit more about the physiology of female orgasm. Please drop me a line if you have questions or would like to share your experiences.